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目的比较瘢痕子宫再次妊娠并进行二次剖宫产产妇与非瘢痕子宫进行剖宫产产妇的临床状态及产后结果观察。方法随机选取2013年9月-2015年8月该院接诊的剖宫产产妇160例,其中瘢痕子宫再次妊娠行二次剖宫产产妇76例为实验组,非瘢痕子宫行剖宫产产妇84例为对照组,统计并分析两组产妇手术时间及出血量、恶露持续时间、术后不良反应及新生儿结局。结果实验组产妇的平均手术时间为(70.33±5.93)min,远高于对照组产妇的(52.61±8.35)min;实验组产妇的平均恶露持续时间为(50.64±13.83)d,长于对照组产妇;实验组产妇的术中出血量为(258.32±71.32)ml,术后出血量为(427.16±11.89)ml,与对照组产妇比较,差异有统计学意义(P<0.05)。实验组产妇出现产后并发症的几率远高于对照组产妇,两组产妇的术中出血原因及产后不良反应发生率比较,差异均有统计学意义(P<0.05);实验组新生儿窒息率远高于对照组,差异有统计学意义(P<0.05);两组新生儿Apgar评分及体重比较,差异均无统计学意义(P>0.05)。结论瘢痕子宫再次妊娠的产妇,二次剖宫产存在较高的危险系数,因此临床医师应慎重选择并给予孕妇更合适的建议。
Objective To compare the clinical status and postnatal outcome of cesarean section after second pregnancy with cesarean scar and second cesarean section. Methods A total of 160 cases of cesarean section were randomly selected from September 2013 to August 2015 in our hospital. Among them, 76 cases of second cesarean section after scar pregnancy were used as experimental group, while non-scarred uterus were performed cesarean section 84 cases as control group, statistics and analysis of maternal operation time and bleeding volume, duration of lochia, postoperative adverse reactions and neonatal outcomes. Results The mean operative time of the maternal group was (70.33 ± 5.93) min in the experimental group, which was significantly higher than that of the control group (52.61 ± 8.35) min. The average lochia duration of the experimental group was (50.64 ± 13.83) d, (258.32 ± 71.32) ml and postoperative bleeding amount was (427.16 ± 11.89) ml, respectively. There was significant difference between the experimental group and the control group (P <0.05). The incidence of postpartum complications in the experimental group was much higher than that in the control group. The causes of intraoperative bleeding and the incidence of postpartum adverse reactions in the two groups were statistically significant (P <0.05). In the experimental group, the rate of neonatal asphyxia Which was significantly higher than that of the control group (P <0.05). There was no significant difference in Apgar score and body weight between the two groups (P> 0.05). Conclusion There is a high risk factor for second pregnancy after scar pregnancy and second cesarean section. Therefore, clinicians should choose carefully and give pregnant women more appropriate advice.